1. SW 644: Issues in Developmental Disabilities Health Promotion for People with Developmental Disabilities Lecture Presenter: William Schwab, M.D.

2. Video of Don Anderson

3. Video of William Schwab

4. Introduction  Physician Education Project - Goals

5. Clinical Care  Story – “Jennifer” Actively resistant client Healthy background Strategies Provider(s) – question of quality / appropriateness of care

6. Medical Screening and Preventative Care  Discussion - “What is Right for Jennifer?”

7. Provider Options - Summary  General anesthesia  Practical sedation  Physical compulsion  Modify testing  Affect change in person  Affect change in environment  Defer screening

8. Advantages of Screening  Advantages and disadvantages

9. Goals  Universal v. same screening

10. Values  Personal autonomy vs. substituted judgment (legal framework)

11. Impact  Effectiveness of early detection  Efficacy of screening test

12. Individualized Risk  Example(s): Screening for cervical cancer Screening for breast cancer

13. Invasiveness  Active submission vs. passive participation

14. Alternatives  Adherence to standard methodology vs. acceptance of modified regimen

15. Physician’s Perspective

16. Health Promotion  Access  Informed decision making  Values – person & circles of support